Healthcare Provider Details

I. General information

NPI: 1235976101
Provider Name (Legal Business Name): CURATED HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2024
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 AVE ASHFORD STE 113A
SAN JUAN PR
00907-1511
US

IV. Provider business mailing address

31 HARBOUR LIGHTS DR
HUMACAO PR
00791-6055
US

V. Phone/Fax

Practice location:
  • Phone: 561-578-1730
  • Fax:
Mailing address:
  • Phone: 561-578-1730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK C BLACKBURN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 561-578-1730